Wake Forest Baptist Health (WFBH) is committed to providing neurology clinical trials to our historically underrepresented and geographically diverse patients across our 6-hospital health system and our 26-county catchment area. Joining the NeuroNEXT network as a clinical site would bring the currently uncovered Southeast Atlantic into the national network and enhance it with our diverse patient mix. Three-quarters of our patients live in rural communities and a substantial proportion are below the federal poverty level. Of note, North Carolina has the largest population of American Indians east of the Mississippi River, and one of the fastest-growing Hispanic populations in the nation. Furthermore, WFBH is one of the few fully integrated academic health systems in the U.S. We bring experience in clinical trials, dedicated leadership, and a successful track record of training the next generation of clinician-scientists in neurology. With a strong commitment of institutional resources from our new CEO/Dean, WFBH has robust research infrastructure that includes our CTSA-funded Clinical and Translational Science Institute (CTSI), Maya Angelou Center for Health Equity, NIA-funded Pepper Older Americans Independence and Alzheimer?s Disease Core Centers, and an outstanding Division of Public Health Sciences with extensive experience with multi-site clinical trials and working with NIH coordinating centers. WFBH is also dedicated to training a diverse next generation of neuroscience investigators. WFBH has received 12 Neuroscience K awards in the last 5 years and Neurology is an institutional leader in clinical trial revenues (17.5% of non-NIH income received by WFBH). With these multiple strengths, we will contribute meaningfully to the NeuroNEXT network by carrying out these Specific Aims: AIM 1: To leverage our geographically, ethnically, and economically diverse catchment area to effectively enroll and retain clinical trial participants from historically underserved populations. This includes western North Carolina and southern Virginia, rural Appalachia, and large urban, Hispanic, and African American populations. AIM 2: To engage our patient community in the research process, leveraging our current stakeholder outreach infrastructure to promote NeuroNEXT trials. AIM 3: To leverage the resources of our integrated academic medical center to incentivize, coordinate, and transparently track clinical trial creation, growth, and implementation. AIM 4: To recruit and train the next generation of neurology researchers to design and implement meaningful and reproducible clinical trials. Our experienced co-PIs, Drs. Brashear and Duncan, together with the entire WFBH research leadership, are enthusiastic in offering to the NeuroNEXT network our unique patient mix, strong investigative group, robust research environment for neurology clinical trials, efficient regulatory and contract execution teams, and expertise in conducting efficient and reproducible trials of promising therapies for neurologic disorders.